Apparatus for supporting and monitoring a person

ABSTRACT

A system includes a person-support structure, a sensor configured to sense a characteristic of a person supported on the person-support structure, and a control configured to calculate a condition score as a function of the characteristic of the person. The control is operable to change a characteristic of the person-support structure as a function of the condition score.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No.13/153,672, filed Jun. 6, 2011, which claims the benefit, under 35U.S.C. §119(e), of U.S. Provisional Application No. 61/352,017 which wasfiled Jun. 7, 2010 and which is hereby incorporated by reference herein.The present application is also a continuation-in-part of U.S.application Ser. No. 14/011,833, filed Aug. 28, 2013, which is acontinuation of U.S. application Ser. No. 12/881,285, filed Sep. 14,2010, now U.S. Pat. No. 8,525,680, which claims the benefit, under 35U.S.C. §119(e), of U.S. Provisional Application Nos. 61/243,714;61/243,741; 61/243,806; and 61/243,825; each of which was filed Sep. 18,2009 and each of which is hereby incorporated by reference herein.

The present application relates to U.S. application Ser. No. 13/153,672,filed Jun. 6, 2011 and titled “Apparatus for Supporting and Monitoring aPerson.”

BACKGROUND

This disclosure relates to person support apparatuses. Moreparticularly, but not exclusively, the present disclosure relates toperson support apparatuses that incorporate or are used with vital signsmonitoring devices and movement detection systems, and prediction of theonset of a condition.

Person support apparatuses can include beds, chairs, stretchers, seats,mattresses, therapy surfaces, furniture, and the like, or otherapparatuses that support a person. Hospital beds and stretchers,hospital mattresses, and wheelchairs are examples of such apparatusesthat support persons. Consumer beds, chairs, and furniture are alsoexamples of such person support apparatuses, as are seats for vehicles,businesses, and venues.

Vital signs monitors monitor one or more physiological parameters of aperson, such as body temperature, pulse rate, heart rate, bloodpressure, and respiratory rate, as well as other body signs, such asend-tidal CO2, SpO2 (saturation of oxygen in arterial blood flow,sometimes referred to as pulse oximetry), and other indicators of theperson's physiological state. Movement and/or position detection systemsmonitor the movement of a person to determine if they are attempting toexit the support apparatus. Movement and/or position detection systemsare sometimes included as part of a hospital bed.

While various systems have been developed, there is still a need forfurther contributions and improvements in these areas of technology,particularly with regard to predicting the onset of an adverse conditionprior to the occurrence of the condition.

SUMMARY

The present disclosure includes one or more of the features recited inthe appended claims and/or the following features which, alone or in anycombination, may comprise patentable subject matter.

According to this disclosure, a method may include receiving an inputsignal from an electronic medical record and configuring aperson-support apparatus as a function of the input signal. The inputsignal may include a fall risk assessment score or a pressure ulcer riskassessment score, for example.

Also according to this disclosure, a method may include sensing acharacteristic of a person supported on a person-support apparatus,calculating a condition score as a function of the characteristic, andconfiguring a support system as a function of the condition score. Thesupport system may include a person-support apparatus or aperson-support surface, for example.

Further according to this disclosure, a method may include sensing acharacteristic of a person supported on a person-support apparatus,calculating a condition score as a function of the characteristic, andconfiguring a communication system as a function of the condition score.The communication system may include a work-flow process program, forexample.

According to this disclosure, a person-support apparatus may include aframe configured to support a person thereon, a sensor configured tosense a characteristic of a person supported on the frame, and a controlconfigured to calculate a condition score as a function of thecharacteristic of the person. The control may be operable to change acharacteristic of the frame as a function of the condition score.

The person-support apparatus may further include a communication deviceconfigured to receive an input signal corresponding to information in anelectronic medical record. The control may calculate the condition scoreas a function of the characteristic of the person and the input signal.The input signal may include a fall risk assessment score or a pressureulcer risk assessment score, for example. The frame of theperson-support apparatus may include an upper frame portion with a deckmovably coupled thereto. The deck may have a head section. The controlmay cause the head section to rotate between a relatively horizontalposition and an inclined position.

It is contemplated by this disclosure that a person-support apparatusmay include a frame configured to support a person thereon, acommunication device configured to receive an input signal correspondingto information in an electronic medical record, and a control configuredto calculate a condition score as a function of the input signal. Thecontrol may be operable to change a characteristic of the frame as afunction of the condition score.

It is also contemplated by this disclosure that a person-support surfacemay be configured to support a person thereon and may include a fluidchamber, a fluid supply configured to supply fluid to the fluid chamber,a communication device configured to receive an input signalcorresponding to information in an electronic medical record, and acontrol configured to calculate a condition score as a function of theinput signal. The control may be operable to control the fluid supply asa function of the condition score.

Further according to this disclosure, a person-support surface may beconfigured to support a person thereon and may include a fluid chamber,a fluid supply configured to supply gas to the fluid chamber, a sensorconfigured to sense a characteristic of a person supported on theperson-support surface, and a control configured to calculate acondition score as a function of the characteristic of the person. Thecontrol may be operable to control the fluid supply as a function of thecondition score.

The person-support surface may further include a communication deviceconfigured to receive an input signal corresponding to information in anelectronic medical record. The control may calculate the condition scoreas a function of the characteristic of the person and the input signal.The input signal may include a fall risk assessment score or a pressureulcer risk assessment score, as noted previously. In some embodiments,the fluid chamber may comprise a temperature and humidity topper.Alternatively or additionally, the fluid chamber may include a gasbladder.

Some embodiments may include a control system for a person supportsystem configured to receive input signals from at least one of a sensorand an electronic medical record (EMR), generate a condition score as afunction of the input that can corresponding to the likelihood of anadverse condition occurring, and alert a caregiver when the conditionscore exceeds a predetermined threshold.

According to this disclosure, therefore, a method may include sensing acharacteristic of a person supported on a person-support apparatus,calculating a condition score as a function of the characteristic, andconfiguring a support system and/or a communication system as a functionof the condition score. The support system may include theperson-support apparatus, such as a bed frame, and/or a person-supportsurface. The condition score may include a fall risk assessment score ora pressure ulcer risk assessment score. The support system may furtherinclude a fluid supply and the configuring may comprise causing thefluid supply to initiate a therapy.

Also according to this disclosure, a system may include a person-supportstructure, a sensor configured to sense a characteristic of a personsupported on the person-support structure, and a control configured tocalculate a condition score as a function of the characteristic of theperson. The control may be operable to change a characteristic of theperson-support structure as a function of the condition score.

The person-support structure may include a bed frame with a movementmechanism. The control may control the movement mechanism as a functionof the condition score to change a characteristic of the bed frame. Insome embodiments, the frame may include an upper frame portion with adeck movably coupled thereto having a head section. The control maycause the head section to rotate between a relatively horizontalposition and an inclined position.

The system may further have a fluid supply and the person-supportstructure may include a fluid chamber configured to receive fluid fromthe fluid supply. The control may control the fluid supply as a functionof the condition score. In some instances, the control may cause thefluid supply to initiate a therapy. It is contemplated by thisdisclosure that the fluid chamber may comprise, for example, at leastone of a temperature and humidity topper, a mattress, and a gas bladder.

The system may further include a communication device configured toreceive an input signal corresponding to information in an electronicmedical record. The control may calculate the condition score as afunction of the characteristic of the person and the input signal. Theinput signal may include a fall risk assessment score or a pressureulcer risk assessment score. The control may calculate the conditionscore as a function of the status of the person-support structure andthe characteristic of the person. In some embodiments, the control maycalculate the condition score as a function of the status of theperson-support structure, an input signal corresponding to informationin an electronic medical record, and the characteristic of the person.

Additional features, which alone or in combination with any otherfeature(s), such as those listed above and/or those listed in theclaims, can comprise patentable subject matter and will become apparentto those skilled in the art upon consideration of the following detaileddescription of various embodiments exemplifying the best mode ofcarrying out the embodiments as presently perceived.

BRIEF DESCRIPTION OF THE DRAWINGS

Referring now to the illustrative examples in the drawings, wherein likenumerals represent the same or similar elements throughout:

FIG. 1 is a diagrammatic view of person monitoring system according toone or more principles of the present disclosure;

FIG. 2 is a perspective side view of the person support apparatus of theperson monitoring system of FIG. 1 according to one illustrativeembodiment;

FIG. 3 is a perspective side view of a person support surface that canbe supported on the person support apparatus of FIG. 2 according to oneillustrative embodiment;

FIG. 4 is a perspective side view of the upper frame of the personsupport apparatus of FIG. 2 according to one illustrative embodiment;

FIG. 5 is diagrammatic view of a control system of the person supportapparatus of FIG. 2 according to one illustrative embodiment including acontroller and a plurality of sensors;

FIG. 6 is a flow chart illustrating a procedure that can be executed bythe controller of the control system of FIG. 5 according to oneillustrative embodiment; and

FIG. 7 is a diagrammatic view of a control system of the person supportapparatus of FIG. 2 according to one illustrative embodiment including acontroller and a plurality of sensors.

DETAILED DESCRIPTION

While the present disclosure can take many different forms, for thepurpose of promoting an understanding of the principles of thedisclosure, reference will now be made to the embodiments illustrated inthe drawings, and specific language will be used to describe the same.No limitation of the scope of the disclosure is thereby intended.Various alterations, further modifications of the described embodiments,and any further applications of the principles of the disclosure, asdescribed herein, are contemplated.

One illustrative embodiment includes a control system coupled to aperson support system configured to receive input signals correspondingto at least one of bed status information, person position, electronicmedical record information, and physiological information, generate acondition score corresponding to the likelihood of an adverse conditionoccurring, and alert a caregiver when the condition score exceeds apredetermined threshold.

A person monitor system 3010 according to one illustrative embodiment ofthe current disclosure is shown in FIG. 1. The person monitor system3010 includes a signaling and communication system 3012 in communicationwith a person support apparatus 3014. The person monitor system 3010 isconfigured to provide caregivers with information about a personsupported on the person support apparatus 3014 through the signaling andcommunication system 3012. In one illustrative embodiment, the signalingand communication system 3012 comprises a patient/nurse call system 3012that, in some embodiments, includes patient stations capable ofgenerating hospital calls and a remote master station which prioritizesand store the calls. One example of such a system is disclosed in U.S.Pat. No. 5,561,412 issued on Oct. 1, 1996 to Novak et al., which isincorporated by reference herein in its entirety. Another example ofsuch a system is disclosed in U.S. Pat. No. 4,967,195 issued on May 8,2006 to Shipley, which is incorporated by reference herein in itsentirety.

In some embodiments, the signaling and communication system 3012includes a system 3012 for transmitting voice and data in packets over anetwork with any suitable number of intra-room networks that can couplea number of data devices to an audio station, where the audio stationcouples the respective intra-room network to a packet based network. Oneexample of such a system is disclosed in U.S. Pat. No. 7,315,535 issuedon Jan. 1, 2008 to Schuman, which is incorporated by reference herein inits entirety. Another example of such a system is disclosed in U.S.Patent Publication No. 2008/0095156 issued on Apr. 24, 2008 to Schuman,which is incorporated by reference herein in its entirety.

According to some embodiments, the signaling and communication system3012 includes a patient/nurse call system, a nurse call/locating badge,an electronic medical record (EMR) database, and one or more computersprogrammed with work-flow process software. One example of such a systemis disclosed in U.S. Patent Publication No. 2008/0094207 published onApr. 24, 2008 to Collins, Jr. et al., which is incorporated by referenceherein in its entirety. Another example of such a system is disclosed inU.S. Patent Publication No. 2007/0210917 published on Sep. 13, 2007 toCollins, Jr. et al., which is incorporated by reference herein in itsentirety. Yet another example of such a system is disclosed in U.S. Pat.No. 7,319,386 published on Jan. 15, 2008 to Collins, Jr. et al., whichis incorporated by reference herein in its entirety. It should beappreciated that the workflow process software can be the NaviCare®software available from Hill-Rom Company, Inc. It should also beappreciated that the workflow process software can be the systemdisclosed in U.S. Pat. No. 7,443,303 issued on Oct. 28, 2008 to Spear etal., which is incorporated by reference herein in its entirety. Itshould further be appreciated that the badge can be of the typeavailable as part of the ComLinx™ system from Hill-Rom Company, Inc. Itshould also be appreciated that the badge can also be of the typeavailable from Vocera Communications, Inc.

According to some embodiments, the remote signaling and communicationsystem 3012 is configured to organize, store, maintain and facilitateretrieval of bed status information, along with the various non-bedcalls placed in a hospital wing or ward, and remotely identify andmonitor the status and location of the person support apparatus,patients, and caregivers. One example of such a system is disclosed inU.S. Pat. No. 7,242,308 issued on Jul. 10, 2007 to Ulrich et al., whichis incorporated by reference herein in its entirety. It should beappreciated that the remote status and location monitoring can be thesystem disclosed in U.S. Pat. No. 7,242,306 issued on Jul. 10, 2007 toWildman et al., which is incorporated by reference herein in itsentirety. It should also be appreciated that the remote status andlocation monitoring can be the system disclosed in U.S. PatentPublication No. 2007/0247316 published on Oct. 25, 2007 to Wildman etal., which is incorporated by reference herein in its entirety.

The person support apparatus 3014 according to one illustrativeembodiment of the current disclosure is shown in FIG. 2. The personsupport apparatus 3014 includes a head section H1, where the head and aportion of the torso of a person are to be positioned, and a footsection F1, where the feet of a person are to be positioned. The personsupport apparatus 3014 includes a lower frame 3016 or base 3016, anupper frame 3018, a plurality of supports 3020, and a control system3022. It should be appreciated that the person support apparatus 3014can include only one support 3016. The lower frame 3016 includes atleast one lower frame section supported by casters 3024. The supports3020 are lift mechanisms 3020 that define a vertical axis Z1 whichextends through the lower frame 3016 and the upper frame 3018 and areconfigured to move the upper frame 3018 with respect to the lower frame3016. It should be appreciated that the supports 3020 can be at leastone fixed column (not shown), if desired. It should also be appreciatedthat, in some embodiments, the supports 3020 move the upper frame 3018to a Trendelenburg/reverse Trendelenburg position and/or rotate theupper frame 3014 from side to side with respect to the lower frame 3012.

The person support apparatus 3014 supports a person support surface 3026on the upper frame 3018 as shown in FIGS. 2 and 3. The person supportsurface 3026 is configured to support a person (not shown) in multiplearticulated positions. The person support surface 3026 includes a backportion B1 and a main portion M1. The person support surface 3026includes an outer cover or ticking C1 that covers one or more supportsections and/or layers having foam and/or fluid bladders 3028. In someembodiments, the person support surface 3026 delivers therapy to theperson, such as, for example, through sequential inflation/deflation ofthe fluid bladders 3028, rapid changes in pressure of the fluid in thefluid bladders 3028, passing fluid through the person support surface3026, and/or various other techniques. For example, in variousembodiments, one or more portions of the surface 3026 providealternating pressure therapy, continuous lateral rotation therapy, lowair loss therapy, boost assistance, percussion/vibration therapy, and/orother therapies. It should also be appreciated that, in someembodiments, the person support surface 3026 includes a coverlet (notshown) that overlies another person support surface 3026 and isconfigured to deliver therapy to a person supported thereon. The personsupport surface 3026 receives fluid from a fluid supply FS connected tothe person support surface 3026 by a connecting tube T1. In someembodiments, the fluid supply FS is a gas blower and is configured tovary at least one of a rate and a temperature of fluid supplied to theperson support surface 3026.

The upper frame 3018 defines a longitudinal axis X1 that extends atleast the length of the person support apparatus 3014 through the headend H1 and the foot end F1 along the lateral center of the upper frame3018, and a lateral axis Y1 that is perpendicular to the longitudinalaxis X1 and extends at least the width of the person support apparatus3014 through the longitudinal center of the upper frame 3018 as shown inFIGS. 2 and 4. The upper frame 3018 includes a deck 3030, anintermediate frame 3032, and an upper frame base 3034 that couples withthe supports 3020 and supports the deck 3030 and the intermediate frame3032. It should be appreciated that the upper frame 3018 includes afootboard FB, a head board HB, and/or siderails SR in some embodiments.The deck 3030 is comprised of multiple sections, such as, a head decksection HD, a seat deck section SD, and a foot deck section FD, that arepivotably coupled to one another and/or the intermediate frame 3032 andarticulate about the lateral axis Y1.

The control system 3022 is configured to control various functions ofthe person support apparatus 3014 and/or communicate with the signalingand communication system 3012 as shown in FIG. 5. Additionally oralternatively, the control system 3022 can be configured to becontrolled through the signaling and communication system 3012, ifdesired. In some embodiments, the control system 3022 is configured toarticulate the deck 3030 with respect to the intermediate frame 3032. Insome embodiments, the control system 3022 is configured to administertherapy to a person supported on the person support apparatus 3014.According to some embodiments, the control system 3022 is configured toalert caregivers when a person is exiting the person support apparatus3014. According to other embodiments, the control system 3022 isconfigured to predict the onset of an adverse condition and alert acaregiver.

The control system 3022 includes a plurality of sensors 3036, controlmodules 3038, and a display 3040 as shown in FIG. 5. The sensors 3036and/or the control modules 3038 are coupled to the upper frame 3018 insome embodiments. It should be appreciated that the sensors 3036 and/orthe control modules 3038 can be coupled to the lower frame 3016,supports 3020, and/or incorporated within or coupled to the personsupport surface 3020 in other embodiments, if desired. In oneillustrative embodiment, the sensors 3036, control modules 3038, and thedisplay 3040 are directly connected to one another. In anotherillustrative embodiment, the sensors 3036, control modules 3038, and thedisplay 3040 are operatively connected to one another through a network3042.

The network 3042 facilitates communication between the various modules3038, sensors 3036, displays 3040, and/or other equipment operativelyconnected to the network 3042. In one illustrative embodiment, thenetwork 3042 comprises a CAN network on a person support apparatus 3014.In another illustrative embodiment, the network 3042 is part of thesignaling and communication system 3012. In some embodiments, thenetwork 3042 comprises a Serial Peripheral Interface (SPI) network. Itshould be appreciated that the network 3042 can be other types ofnetworks or communication protocols that can facilitate communicationbetween two or more devices. It should also be appreciated that themodule 3038 can be configured to connect to the network 3042 wirelessly,if desired. In one illustrative embodiment, the control module 3038negotiates with the network 3042 to be a network node. According to someembodiments contemplated by this disclosure, the control modules 3038can be located at or on any node on the network 3042 and/or distributedacross multiple nodes on the network 3042.

In the illustrative example, the sensors 3036 are operatively connectedto the control modules 3038 and include sensors that contact the person(contact sensors 3044) and/or sensors that do not contact the person(contact-less sensors 3046) as shown in FIG. 5. In one illustrativeembodiment, the contact sensors 3044 contact a person's tissue tomeasure the desired parameter. In another illustrative embodiment, thecontact-less sensors 3046 are integrated into the person support surface3026. It should be appreciated that the contact-less sensors 3046 can beintegrated into the portion of the ticking C1 contacting the person, ifdesired. In some embodiments, the contact-less sensors 3046 are coupledto at least one of the upper frame 3018, the supports 3020, and/or thelower frame 3016. It should be appreciated that the contact-less sensors3046 can be coupled to the casters 3024 and/or engaged by the casters3024, if desired.

The sensors 3036 are configured to sense a variety of parameters,including, but not limited to, for example, a person's physiologicalinformation, a position of a person on the person support apparatus 3014and/or person support surface 3026, a pressure of the fluid inside thebladders 3028 in the person support surface 3026, or other variousparameters. In one illustrative embodiment, the contact sensors 3044include blood pressure sensors 3048 that are configured to sense theperson's blood pressure; oxygen saturation level (SpO2) sensors 3050that are configured to sense the amount of hemoglobin binding sites inthe person's bloodstream occupied by oxygen; temperature sensors 3052that are configured to sense the person's body temperature; heart ratesensors 3054 that are configured to sense the rate at which a person'sheart contracts; and respiration rate sensors 3056 that are configuredto sense the person's breathing rate as shown in FIG. 5. It should beappreciated that the SpO2 sensors 3050 comprise a pulse oximeter devicein some embodiments. It should be appreciated that the contact sensors3044 are configured to measure other physiological and biochemicalparameters in other embodiments.

In some embodiments, the contact-less sensors 3046 include one or moreof the following: force sensors 3058 configured to sense the forceprofile and/or distribution of a person supported on a person supportapparatus 3014; pressure sensors 3060 configured to measure the pressurein or among the bladders 3028; temperature sensors 3062 configured tosense the person's body temperature; heart rate sensors 3064 configuredto sense the rate at which the person's heart contracts; respirationrate sensors 3066 configured to sense the person's breathing rate; andother sensors configured to sense information corresponding to thestatus of the person-support apparatus 3014, such as, for example, theangle of the head deck section HD with respect to the longitudinal axisX1 as shown in FIG. 5.

In some embodiments, the force sensors 3058 are load cells 3058 thatcouple the intermediate frame 3032 to the upper frame base 3034proximate the corners of the upper frame 3018 and are configured tomeasure the weight of a person on the person support apparatus 3014.Alternatively or additionally, the force sensors 3058 comprisepiezoelectric sensors and/or elongated sensor strips or arrays 3058 insome embodiments. In some embodiments, the pressure sensors 3060 arecoupled between the bladders 3028 such that they allow communicationbetween adjacent bladders 3028. In some embodiments, pressure sensors3060 are situated within the bladders 3028 and measure the pressurewithin the bladder 3028.

In some embodiments, the heart rate sensors 3064 and respiration ratesensors 3066 are integrated into the surface 3026. In some embodimentscontemplated herein, the heart rate sensors 3064 and respiration ratesensors 3066 are force sensors 3058 and/or pressure sensors 3060. Itwill be appreciated that the sensors 3036 are configured to sensevarious other physiological characteristics. In some embodiments, theheart rate sensors 3064 and respiration rate sensors 3066 arepressure-strip sensors disposed on the fluid bladders 3028 along an axisparallel to the lateral axis Y1 and/or along an axis parallel to thelongitudinal axis X1.

The control modules 3038 can each be configured to perform differentoperations, if desired. According to this disclosure, a single controlmodule 3038 can be configured to perform the multiple differentoperations if desired. Optionally, a single control module 3038 can beconfigured to perform operations independently or in conjunction with atleast one other control module 3038. In one contemplated embodiment, onecontrol module 3038, such as, a person position monitor module (notshown) (PPM), is configured to detect the position of a person on theperson support apparatus 3014. Alternatively or additionally, a secondcontrol module 3038, such as a therapy control module (not shown), isconfigured to sense and/or modify the pressure within the fluid bladders3028. Optionally, a third control module 3038, such as a physiologicalparameter monitor (not shown), is configured to detect a person'sphysiological information. In some embodiments, a fourth control module3038, such as a wake up detector (not shown), is configured to detectwhen a person is regaining consciousness.

In some contemplated embodiments, a fifth control module 3038, such as,a person-support apparatus configuration module (not shown), configuresthe person-support apparatus 3014 as a function of an input signal.Additionally or alternatively, the person-support apparatus 3014 streamsinformation to the control system 3022, such as, the Navicare system,which configures the person-support apparatus 3014 based on theinformation. The input signal includes information from the EMR, a userinput through the interface, i.e., user interface, a physiologicalcharacteristic of a person supported on the person-support apparatus3014, or other information or combinations thereof. In one example, thecontrol module 3038 automatically activates alarms, such as, a bed exitalarm, siderail-down alarm, head of bed angle, wheel brake not set,person-support apparatus 3014 not in lowest position, based oninformation from the EMR, such as, a fall risk assessment score. In someembodiments, the control module 3038 prompts the caregiver and asks themif they want to apply the fall risk protocol. Also, in some embodiments,the control module 3038 automatically applies the protocol. Further, insome embodiments, the control module 3038 configures the person-supportapparatus 3014 based on a remote signal, such as, a signal from the EMRor a remote interface, without a caregiver present.

In another example, the fifth control module 3038 automaticallyactivates therapies, such as, low-air loss therapy, percussionvibration, lateral rotation, microclimate management, heating/cooling,and/or other therapies, based on information from the EMR, such as, apressure ulcer assessment score. In another example, the control module3038 changes the angle of at least one section of the deck 3030 based ona change in the respiration rate or heart rate of a person. In anotherexample, the control module 3038 changes the height of the upper frame3018 with respect to the lower frame 3016 based on a fall risk protocol.In another example, the control module 3014 configures theperson-support apparatus 3014 based on the center of gravity of theperson. In another example, the control module 3038 configures theperson-support apparatus 3014 based on the person'sphysiology/morphology (a person having no legs might be more prone totriggering an out of position alarm versus a bed exit alarm). In anotherexample, the control module 3038 configures the person-support apparatus3014 based on the output from one of the other modules, such as, theperson position monitor module, the therapy control module, thephysiological parameter monitor, the wake up detector, or other modules.In another example, the control module 3038 configures theperson-support apparatus 3014 based on an adverse condition predictionscore (described below). In some embodiments, the communication system3012 configures itself as a function of an input signals described aboveand can receive data from the person-support apparatus 3014.

Once the fifth control module 3038 has configured the person-supportapparatus 3014, the control module 3038 inputs the person-support statusinformation and/or the person's status information into the EMR (orconfirm that the recommended action was taken). Alternatively oradditionally, the caregiver must acknowledge that a task or function wascompleted through the interface, i.e., user interface, and theacknowledgement is also input into the EMR by the control module 3038.In some embodiments, the communication system 3012 inputs theperson-support status information and/or the person's status informationinto the EMR.

The control modules 3038 are implemented using software or hardware. Insome embodiments, the control modules 3038 are implemented in softwareand are configured to perform one or more operations. In someembodiments, for example, the modules 3038 are configured to communicatevia a memory mailbox where information from one module is sent to thememory address of a recipient module. In other embodiments, the softwaremodules are configured to push information in a memory location, suchas, a stack, that the control modules 3038 monitor or periodically checkfor information that the software modules subscribe to.

In contemplated embodiments, the control module 3038 is implementedusing hardware. The control module 3038 includes a controller 3074 orprocessor 3074 and memory 3076 as shown in FIG. 5. The controller 3074is provided as a single component or a collection of operatively coupledcomponents; and can be comprised of digital circuitry, analog circuitry,or a hybrid combination of both of these types. When of amulti-component form, controller 3074 has one or more componentsremotely located relative to the others. The controller 3074 can includemultiple processing units arranged to operate independently, in apipeline processing arrangement, in a parallel processing arrangement,and/or such different arrangement as would occur to those skilled in theart.

In some embodiments, processor 3074 is a programmable microprocessingdevice of a solid-state, integrated circuit type that includes one ormore processing units and memory. The controller 3074 can include one ormore signal conditioners, modulators, demodulators, Arithmetic LogicUnits (ALUs), Central Processing Units (CPUs), limiters, oscillators,control clocks, amplifiers, signal conditioners, filters, formatconverters, communication ports, clamps, delay devices, memory devices,and/or different circuitry or functional components as would occur tothose skilled in the art to perform the desired communications. In someembodiments, the controller 3074 includes a computer network interfaceto communicate among various system components and/or components notincluded in the depicted system, as desired. The listed examples are notintended to be an exhaustive list of structures that are within thescope of controller 3074, but are instead only a non-exhaustive list ofsuch structures which can have substantial differences in the manner inwhich they are implemented and/or operate.

The controller 3074 is configured to receive input signals correspondingto signals from the sensors 3036 and/or output signals from othermodules 3038 via the network 3042. The information is stored in thememory 3076, which is operatively coupled to the controller 3074 asshown in FIG. 5. It should be appreciated that the memory 3076 isintegrated into the controller in some embodiments. The controller 3074is configured to execute operating logic 3078 that defines variouscontrol, management, and/or regulation functions. This operating logic3078 can be in the form of software, firmware, and/or dedicatedhardware, such as, a series of programmed instructions, code, electronicfiles, or commands using general purpose or special purpose programminglanguages or programs that are executed on one or more general purposeor special purpose computers, processors, other control circuitry, ornetworks; a hardwired state machine; and/or a different form as wouldoccur to those skilled in the art.

In the illustrative embodiment, the controller 3074 includes operatinglogic 3078 in the form of procedure 3080, for example, as shown in theflowchart of FIG. 6. Procedure 3080 includes operations/conditionalsshown at blocks 3082, 3084, 3086, and 3088. Procedure 3080 is used togenerate a condition score corresponding to the condition of a person,which is compared to a threshold in order to predict the onset of anadverse condition.

The thresholds are established in accordance with hospital specificstandard protocols and/or are generic thresholds that can be modified asdesired. In some embodiments, the preset thresholds that are set bystandard hospital specific protocols, which are automatically selectedbased on information present in a person's electronic medical record(EMR), in patient profiles, and/or based on the condition scoregenerated by the procedure 3080. Alternatively or additionally, thethresholds are set by a caregiver through an interface (not shown) onthe person-support apparatus 3014 by manually selecting the protocols ormodifying the generic thresholds. In some contemplated embodiments, thethresholds are automatically modified based on information in theperson's electronic medical record (EMR). It should be appreciated thatthe thresholds can be person specific and can be incorporated into theperson's EMR. It should also be appreciated that the thresholds can beincorporated into a patient profile that can be used for multiple peoplewith similar characteristics. In some embodiments, the thresholds aremodified by a caregiver through the signaling and communication system3012.

Illustrative procedure 3080 begins with operation 3082 where, in oneillustrative embodiment, the sensors 3036 post electronic data signalscorresponding to at least one of an event and an amount on the network3042. In some embodiments, the sensors 3036 post electronic data signalsto a memory mailbox or register (not shown) where the modules 3038 areimplemented in software. In some embodiments, sensors 3036 post datasignals substantially continuously and, in other embodiments, sensors3036 post data signals at predetermined intervals. The data signals fromsensors 3036 are representative of heart rate, respiration rate,temperature, blood pressure and/or SpO2 as indicated at block 3082 ofFIG. 6. Data signals corresponding to features of the person supportapparatus 3014 are also posted to the network such as, for example,signals from force sensors 3044 of a patient position and/or movementmonitoring system of apparatus 3014 and are used in a similar manner assignals from sensors 3036 in procedure 3080.

In the conditional of block 3084, the controller 3074 examines each ofthe data signals posted by the sensors 3036 on the network 3042 anddetermines if the associated module 3038 subscribes to the data. If themodule 3038 does not subscribe to the data, then the algorithm returnsto block 3082 and awaits more incoming data.

If at block 3084 it is determined that module 3038 subscribes to thedata, the algorithm proceeds to the operation of block 3086 and the datais input into an algorithm that is used to predict an adverse event orcondition. In some embodiments, the data signals can be used to selectone or more standard hospital specific protocols, which, in someinstances, have predetermined thresholds associated therewith.Alternatively or additionally, the data signals can be input into analgorithm that is used to select the hospital specific protocols and/orto set the predetermined thresholds associated with the protocols.

In the operation of block 3088, the controller 3074 executes thealgorithm to generate a condition score corresponding to the conditionof the person and/or to generate a graphic representative of thecondition of the person. In one embodiment, the algorithm receivesinputs from the contact-less sensors 3046 corresponding to the heartrate, respiration rate, and temperature of a person, and inputs from thecontact sensors 3044 corresponding to the blood pressure and SpO2 of aperson. It should be understood that all of the inputs can be from thecontact sensors 3044 in other embodiments. The controller 3074 processesthe data inputs in accordance with the algorithm to calculate thecondition score and/or generate the graphic.

In some embodiments, the algorithm combines the inputs into a datapoint, which is used to calculate a condition score constituting aone-dimensional visualization space based on the distance of the datapoint in a multi-dimensional measurement space, whose coordinates aredefined by values of the inputs, from a normal point. In othercontemplated embodiments, the algorithm maps the inputs from ann-dimensional measurement space to an m-dimensional visualization spaceusing a dimensionality reduction mapping technique, and displays them-dimensional visualization space on the display 3040. One example ofsuch a system using this algorithm and technique is disclosed in U.S.Pat. No. 7,031,857 issued on Apr. 18, 2006 to Tarassenko et al., whichis hereby incorporated by reference herein in its entirety. Onecondition score in accordance with the teachings of U.S. Pat. No.7,031,857 is know as a Visensia® index that can be produced by theVisensia® system sold by OBS Medical, for example. The Visensia® indexcreates a score based on heart rate, respiration rate, blood pressure,temperature, and SpO2 data.

Based on the foregoing, it will be understood that the Visensia® indexis a condition score that is based on, or a function of, only a person'sphysiological data. According to this disclosure, some or all of thephysiological data used to calculate the Visensia® index is obtained byone or more sensors included as part of the person support apparatus3014. This distinguishes over the known prior art. To the extent thatsome of the physiological data needed to calculate a condition score,such as the Visensia® index, is obtained by equipment and/or sensorsthat are not included as part of person support apparatus 3014, suchdata is transmitted to controller 3074 in accordance with thisdisclosure for the purpose of calculating the condition score. Forexample, data is transmitted to controller 3074 from a person's EMR insome instances as suggested diagrammatically in FIG. 5. In otherinstances, person support apparatus 3014 is communicatively coupled tophysiological monitoring equipment that is co-located with apparatus3014 to obtain the needed data for calculating a condition score. In thepreceding examples, controller 3074 automatically initiates the queriesto obtain the needed data from the EMR or co-located equipment and/orpicks up the needed data from network transmissions. Thus, controller3074 automatically calculates the condition score without the need forany further actions on the part of caregivers or users. However, it iswithin the scope of this disclosure for some or all of the neededphysiological data to be entered by a caregiver using a user interfaceof the apparatus 3014.

In another contemplated embodiment, the condition score comprises amodified early warning score (MEWS). According to this disclosure, thedata needed to calculate the MEWS is obtained from sensors included aspart of person support apparatus 3014, obtained via manual user inputs,obtained from separate monitoring equipment that communicates withcontroller 3074 of apparatus 3014, and/or obtained from the person'sEMR. The MEWS is a known score calculated based on the following table:

Score 3 2 1 0 1 2 3 Systolic BP <70 71-80 81-100 101-199  — >200   —Heart rate (BPM) — <40 41-50  51-100 101-110 111-129 >130 Respiratoryrate —  <9 — 9-14 15-20 21-29  >30 (RPM) Temperature (° C.) — <35 —35.0-38.4  — >38.5 — AVPU — — — A V P U

In the MEWS table, the various integers in the column headings are addedtogether based on the various readings for the person of the datacorresponding to the rows of the table. A score of 5 or greaterindicates a likelihood of death. With regard to the systolic bloodpressure, heart rate, respiratory rate, and temperature portions of theMEWS, those pieces of information are obtained using sensors 3036 ofperson support apparatus 3014 and/or using the other manners ofobtaining a person's physiological data as discussed above. It iscontemplated by this disclosure that the AVPU portion of the MEWS isobtained using information from the person support apparatus 3014 asdiscussed below.

The AVPU portion of the MEWS indicates whether a person is alert (A),responsive to voice (V), responsive to pain (P), or unresponsive (U). Asdiscussed above, the person support apparatus 3014 in some embodimentscomprises a hospital bed having a patient position monitoring systemincluding sensors, such as load cells, piezoelectric sensors, and/orforce sensitive resistors (FSR's) which sense a patient's positionand/or movement. In accordance with this disclosure, the patientmovement information is used by the controller to automatically assignan appropriate integer corresponding to the A portion or the U portionof the AVPU line of the MEWS depending upon the amount of movement ofthe patient. For example, if the patient has not moved for a thresholdamount of time, such as fifteen minutes or an hour or some thresholdgreater than or less than these particular times, then the integerassociated with the U portion of the AVPU line of the MEWS is assignedautomatically by controller 3074. If the patient has moved by athreshold amount within a particular time period, then the integerassociated with the A portion of the AVPU line of the MEWS is assignedautomatically by controller 3074.

It is contemplated by this disclosure that the controller 3074 initiatesa voice query to the person in some embodiments. If the person answersthe voice query orally or by engaging a designated user input, such aspressing a particular button mentioned in the voice query, then thecontroller 3074 automatically assigns an appropriate integercorresponding to the V portion of the MEWS. The voice query is apre-recorded message in some embodiments. The voice query is initiatedby controller 3074 if the person has been inactive for the thresholdperiod of time. In other words, in some embodiments, the voice query isinitiated only after the conditions for assigning the U portion of theMEWS has been satisfied. Thus, if the person responds properly to thevoice query, the AVPU portion of the MEWS is assigned as V rather thanU. Apparatus 3014, therefore, has speakers or similar suchsound-producing devices through which the voice query is played and, insome instances, a microphone that picks up the person's oral response.Appropriate interactive voice recognition (IVR) software is provided insuch embodiments.

With regard to determining whether to select the P portion of the AVPUline of the MEWS score, apparatus 3014 is operated to inflict someamount of discomfort to the patient and then monitors the person'sresponse, such as an oral response or movement. For example, in someembodiments, apparatus 3014 includes an inflatable cuff or sleeve placedon a limb of the person and the controller 3074 controls inflation anddeflation of the cuff or sleeve. If the patient movement informationindicates sufficient patient movement by the patient in response toinflation of the cuff or sleeve, then the controller automaticallyassigns the appropriate integer corresponding to the P portion of theAVPU line of the MEWS. Alternatively or additionally, a microphone isused to determine if the patient expresses an audible pain or discomfortsound at which point the integer associated with the P portion of theAVPU line of the MEWS is assigned. The steps for determining whether toassign the P integer are performed only after the steps for determiningwhether to assign the U integer and/or the V integer in someembodiments. That is, operating the person apparatus 3014 so as to causethe patient some discomfort is only done as a last resort. In assigningthe AVPU integer in the MEWS, it will be appreciated that it is thelowest pertinent integer that is assigned. Clearly, an alert personwould also be responsive to voice for example.

The MEWS and Visensia® index discussed above are just a couple ofexamples of condition scores according to this disclosure. The teachingsof this disclosure are intended to be broadly applicable to all types ofcondition scores.

Referring once again to FIG. 6, in the operation of block 3090, thecontroller 3074 compares the calculated condition score (referred tosometimes in FIG. 6 as an “index value” or simply an “index”) with thepredetermined thresholds to determine at least one of the likelihoodthat an adverse condition will occur, an amount of time before anadverse condition will occur, and/or how close the condition score is tothe threshold.

In the conditional of block 3100, if the controller 3074 determines thatthe condition score is greater than the threshold, then, in oneillustrative embodiment, a status update including the condition scoreis communicated to a caregiver through the signaling and communicationsystem 3012 and/or is displayed on the display 3040 as indicated atblock 3110. That is, if the condition score exceeds the threshold, then,in some embodiments, at least one of the condition score and an alertsignal are communicated to a caregiver. In other embodiments, the alertcondition may correspond to the condition score being less than, ratherthan greater than, a particular threshold. The term “greater than” isintended to cover one or both of a greater than situation and a greaterthan or equal to situation and the term “less than” is intended to coverone or both of a less than situation and a less than or equal tosituation.

As alluded to above, in some embodiments, the condition score and/oralert signal are communicated to a caregiver through the signaling andcommunication system 3012. Alternatively or additionally, the conditionscore and/or alert signal are displayed on the display 3040. In stillother embodiments, the condition score and/or alert signal arecommunicated to the Visensia® Alert system sold by OBS Medical. Infurther embodiments, the condition score is communicated to and storedin the person's EMR.

The display 3040 is any suitable display such as a liquid crystaldisplay, touch screen display, plasma screen, light emitting diodedisplay, cathode ray tube display, or other conventional display. Thedisplay 3040 is operable to display multiple parameters thereon alongwith the condition score in some embodiments. In some contemplatedembodiments, the display 3040 displays physiological and/or biochemicalinformation sensed by contact sensors 3044 along with the conditionscore. Thus, it is within the scope of this disclosure for the display3040 to display physiological and/or biochemical information on thedisplay 3040 along with the condition score. In yet other embodiments,the display 3040 displays bed status information and/or graphics, forexample, a head deck section HD angle or PPM armed indicator, on thedisplay along with the condition score. In still other contemplatedexamples, the display 3040 displays bed status information and/orgraphics along with patient condition graphics, such as, pie charts.Other information that is displayable on the display 3040 includes forceprofile information and/or graphics, person position information and/orgraphics, weight, and other physiological information.

Referring now to FIG. 7, the sensors 3036 are operatively coupled to thecontrol modules 3038 and are configured to sense various parameters,including, but not limited to, for example, a person's physiologicalinformation, a position of a person on the person support apparatus 3014and/or person support surface 3026, a pressure of the fluid inside thebladders 3028 in the person support surface 3026, or other variousparameters. As mentioned above, the sensors 3036 can be sensorsconfigured to contact the tissue of a person and/or sensors configuredto not contact the tissue of a person. In some embodiments, the sensors3036 are force sensors 3044 coupled to the upper frame 3018 and areconfigured to measure force on the upper frame 3018 as shown in FIGS. 4and 7. In some embodiments, the sensors 3036 are force sensors 3044 thatmeasure force on the upper frame 3018 and are positioned between theintermediate frame 3032 and the upper frame base 3034 so as to couplethe intermediate frame 3032 and deck 3030 to the upper frame base 3034.

In some contemplated embodiments, the sensors 3036 are force sensors3044 integrated into the person support surface 3026 and configured tomeasure changes in force on the person support surface 3026 as shown inFIG. 4. Alternatively or additionally, the force sensors 3044 arecoupled to the supports 3020 and/or the lower frame 3016. Sensors 3044integrated into the casters 3024 and/or engaged by the casters 3024 arealso within the scope of this disclosure. In some embodiments, the forcesensors 3044 are load cells that are coupled proximate the corners ofthe intermediate frame 3032. In other embodiments, the sensors 3044 arepiezoelectric sensors and/or elongated sensor strips or arrays 3038. Itwill be appreciated that the force sensors 3044 comprising other forcesensor types can be provided and positioned in other locations on theupper frame 3018 and/or within the person support surface 3026.

In some embodiments, the sensors 3036 are pressure sensors 3046integrated into the person support surface 3026 and configured tomeasure the pressure in or among the fluid bladders 3028 in the personsupport surface 3026 as shown diagrammatically in FIG. 7. The pressuresensors 3046 are coupled between the bladders 3028 in some embodimentssuch that they can allow communication between adjacent bladders 3028.It should be appreciated that the pressure sensors can be situatedwithin the bladders 3028 and/or otherwise positioned to measure thepressure within the bladder 3028. Pressure sensors 3046 coupled tobladders 3028 via pneumatic tubes, hoses, or other types of conduits arecontemplated by this disclosure as well.

In some embodiments, the sensors 3036 are physiological sensors 3048integrated into the person support surface 3026 and configured tomeasure various physiological parameters of a person supported on theperson support surface 3026 as suggested in FIG. 7. Optionally, thephysiological sensors 3048 can be coupled to the upper frame 3018, thesupports 3020, and/or the lower frame 3016 in lieu of being coupled tothe mattress 3046. As indicated above, the force sensor 3044 and/orpressure sensor 3046 are configured to sense physiological parameters insome embodiments. For example, one or more of the physiological sensors3048 are used to sense the heart rate and/or respiration rate of aperson supported on the person support surface 3026 in some embodiments.Alternatively or additionally, one or more of the physiological sensors3048 are configured to sense the temperature of the person. In someembodiments, the physiological sensors 3048 are configured to sense theweight of the person on the person support surface 3026. In someembodiments, the physiological sensors 3048 are pressure-strip sensorsdisposed on the fluid bladders 3028 along an axis parallel to thelateral axis Y1 and/or along an axis parallel with the longitudinal axisX1.

In some embodiments, one or more of the sensors 3036 produces an analogdata signal and is connected directly to the controller 3074. In otherembodiments, one or more of the sensors 3036 produce a digital datasignal, e.g., a serial digital data signal, and are connected to thenetwork 3042, e.g., SPI network, to communicate with the controller3074. The data signals can be stored in the memory 3076, which isoperatively coupled with the controller 3074. As mentioned above, thememory 3076 is integrated into the controller 3074 in some embodiments.

In some embodiments, the controller 3074 executes operating logic thatdefines various control, management, and/or regulation functions. Thisoperating logic can be in the form of software, firmware, and/ordedicated hardware, such as, a series of programmed instructions, code,electronic files, or commands using general purpose or special purposeprogramming languages or programs that can be executed on one or moregeneral purpose or special purpose computers, processors, other controlcircuitry, or networks; a hardwired state machine; and/or a differentform as would occur to those skilled in the art.

Any theory, mechanism of operation, proof, or finding stated herein ismeant to further enhance understanding of principles of the presentdisclosure and is not intended to make the present disclosure in any waydependent upon such theory, mechanism of operation, illustrativeembodiment, proof, or finding. It should be understood that while theuse of the word preferable, preferably or preferred in the descriptionabove indicates that the feature so described can be more desirable, itnonetheless can not be necessary and embodiments lacking the same can becontemplated as within the scope of the disclosure, that scope beingdefined by the claims that follow.

In reading the claims it is intended that when words such as “a,” “an,”“at least one,” “at least a portion” are used there is no intention tolimit the claim to only one item unless specifically stated to thecontrary in the claim. When the language “at least a portion” and/or “aportion” is used the item can include a portion and/or the entire itemunless specifically stated to the contrary.

While embodiments of the disclosure have been illustrated and describedin detail in the drawings and foregoing description, the same are to beconsidered as illustrative and not restrictive in character, it beingunderstood that only the selected embodiments have been shown anddescribed and that all changes, modifications and equivalents that comewithin the spirit of the disclosure as defined herein or by any of thefollowing claims are desired to be protected.

The invention claimed is:
 1. A method comprising sensing acharacteristic of a person supported on a person-support apparatus, thecharacteristic being a physiological parameter of the person,calculating a condition score as a function of the characteristic,configuring the person-support apparatus as a function of the conditionscore, and displaying the condition score on a graphical display of theperson-support apparatus, wherein configuring the person-supportapparatus as a function of the condition score includes controlling amovement mechanism of the person-support apparatus as a function of thecondition score to change a characteristic of a bed frame of theperson-support apparatus, wherein the bed frame of the person-supportapparatus includes an upper frame portion with a deck movably couplethereto having a head section, and wherein controlling the movementmechanism results in the head section rotating between a relativelyhorizontal position and an inclined position based on the conditionscore.
 2. The method of claim 1, wherein the person-support apparatusincludes a person-support surface.
 3. The method of claim 1, wherein thecondition score includes a fall risk assessment score or a pressureulcer risk assessment score.
 4. The method of claim 1, wherein theperson-support apparatus includes a fluid supply and the configuringcomprises causing the fluid supply to initiate a therapy.
 5. A systemcomprising: a person-support structure, a sensor configured to sense acharacteristic of a person supported on the person-support structure,the characteristic being a physiological parameter of the person, and acontrol configured to calculate a condition score as a function of thecharacteristic of the person, the control being operable to change acharacteristic of the person-support structure as a function of thecondition score and to display the condition score on a graphicaldisplay of the person-support structure, wherein the person-supportstructure includes a bed frame with a movement mechanism, the controlcontrolling the movement mechanism as a function of the condition scoreto change a characteristic of the bed frame, wherein the frame includesan upper frame portion with a deck movably coupled thereto having a headsection, the control causing the movement mechanism to move the headsection to rotate between a relatively horizontal position and aninclined position based on the condition score.
 6. The system of claim5, further comprising a fluid supply, the person-support structureincluding a fluid chamber configured to receive fluid from the fluidsupply, and the control controlling the fluid supply as a function ofthe condition score.
 7. The system of claim 6, wherein the controlcauses the fluid supply to initiate a therapy.
 8. The system of claim 6,wherein the fluid chamber comprises at least one of a temperature andhumidity topper, a mattress, and a gas bladder.
 9. The system of claim5, further comprising a communication device configured to receive aninput signal corresponding to information in an electronic medicalrecord, the control calculating the condition score as a function of thecharacteristic of the person and the input signal.
 10. The system ofclaim 5, wherein the input signal includes a fall risk assessment scoreor a pressure ulcer risk assessment score.
 11. The system of claim 5,wherein the control calculates the condition score as a function of astatus of the person-support structure and the characteristic of theperson.
 12. The system of claim 5, wherein the control calculates thecondition score as a function of a status of the person-supportstructure, an input signal corresponding to information in an electronicmedical record, and the characteristic of the person.